A place to age in grace / Elder-care innovators make senior citizens a vital part of the urban experience

Amelia Glynn, Special to The Chronicle

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4:00 am PDT, Sunday, April 23, 2006

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Photo: Katy Raddatz

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A place to age in grace / Elder-care innovators make senior citizens a vital part of the urban experience

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What if we couldn't wait to be old and wise, just like kids can't wait to be teenagers and drive? Nader Shabahangi believes becoming an elder is something to be celebrated. Instead of accepting old age as a sentence of doddering obsolescence, he believes our elderly have a lifetime of experience and skills that make them vital contributors to society.

Shabahangi is the visionary behind AgeSong, a company that has built two elder-care communities and has more on the way. They are a far cry from your grandfather's old-folks home, and not only because they are located smack in the middle of San Francisco's thriving Hayes Valley. If you didn't know better, you might assume AgeSong's newest community, Laguna Grove Care, which opened in August, is a loft space for Hayes Valley hipsters.

AgeSong's business model is based on two simple ideas: Older people will thrive in an assisted-care home if it's built to resemble living in their own house; and when elder-care communities are designed to be good architectural neighbors, they will be readily welcomed into mixed-use urban settings.

So far, both are proving true.

The accidental developer

Becoming caretakers for the elderly happened to Shabahangi, and subsequently, his two brothers, more than they consciously chose it. In 1994, he was finishing his doctorate in humanities at Stanford University when some friends enlisted his skills as a contractor to help them expand their board-and-care home for the elderly.

"It was a beautiful, older San Francisco building that overlooked the Pacific Ocean," he says. When he began visiting other care homes to research design ideas for the expansion, he was disturbed by what he discovered: "warehousing of the elderly" in conditions that were often grim and institutionalized.

"That experience really shocked me and it became my mission to do something about it," says Shabahangi. He gathered with his two brothers, Ali and Amir, in their tiny Mission District apartment and shared his desire to change Western society's view of aging and the elderly. This discussion, and the many that followed, became the impetus for the creation of Hayes Valley Care, a 47-bed assisted-living community for elders.

Together, in 1995, the three brothers funded its design and construction with their meager savings and "lots of credit card debt." They paid $625,000 for the property and more than $2 million in remodeling costs. "We wanted Italian tile and high ceilings. We didn't skimp," says Shabahangi. "We believed, and still believe, that attention to detail and the quality of our building materials directly reflects on the quality of care we provide."

Two years later, they were admitting their first residents, which they got solely by word of mouth. "We opened our doors at 1 p.m. and by 4 p.m. we had our first two residents. By 6 p.m., it dawned on us that we needed to feed them. We didn't have a cook -- it was just Ali, Amir and I. So we became their caregivers, cooks and cleaners in addition to running the business end of things," Shabahangi says.

Within another year, the brothers had created a community that answered their vision and became a successful business -- one that included partnering with a Brazilian couple to open a restaurant on the ground floor that also served as a place friends and family of the residents could gather.

In 2000, joined by their sister Elke Tekin and fifth business partner, Chad Lewis, they created AgeSong. Five years later, they opened Laguna Grove Care and now have two more AgeSong community projects in the works -- 88-bed AgeSong Boulevard at 580 Hayes St. and 145-bed AgeSong Emeryville, at 4050 Horton Ave, just a stone's throw from Pixar and the Bay Street Marketplace.

AgeSong Boulevard is estimated to cost $10 million in construction and will break ground in the fall. AgeSong Emeryville is estimated to cost $25 million and will break ground this winter. Meanwhile, the company is looking for opportunities to expand in the South and North Bay.

A modern approach

AgeSong bought what is now the Laguna Grove Care community in two parcels. The corner building was purchased in May 2002 with the intention of creating a 20-bed extension of Hayes Valley Care.

Six months later, when the team realized the building next door was leaning onto their property, they bought it, too, and then tore both buildings down.

The team was divided between wanting a traditional design and a more contemporary one. "Design is a very subjective thing, and at times we had fireworks," says Leila Bijan, the architect. The fight between square corners and round began.

"A lot of love, care, and arguing went in to the creation of our newest building -- not to mention countless family-therapy hours and an exploding budget," Shabahangi says. Construction costs totaled $3 million.

Located at Laguna and Ivy streets, Laguna Grove Care's architecture is surprisingly modern. Stucco towers on the facade alternate between ironwood-slatted columns of large, bay windows. The spacious, light-filled entryway welcomes residents and visitors from the street, visually connecting the building with the outside world.

Bijan describes the lobby and the dining rooms and common areas on the floors above as the "transparent core" of the building. "These areas invite the city inside and help integrate elders into their urban surroundings," she says.

In contrast, the residents' rooms that radiate from the core are kept more private, with their solid wood doors, skylights and floor-to-ceiling windows. This clear delineation between public and private space is one of the core concepts of her design.

The windows throughout Laguna Grove Care are placed so that all residents can comfortably look outside from their wheelchairs or while sitting in a chair or on their bed, encouraging an immediate and ongoing connection with the outside world. "The use of natural light throughout the building was very important," Bijan says.

Limestone flooring, decorative tiles, cherry cabinets and glass bathroom tiles reflect a home, rather than an institutional space. "We chose materials that feel good under your feet and against your hands," Bijan says.

Dining rooms and lounges on each floor eliminate the need for long hallways. The high ceilings -- 11 feet in the residents' rooms and common areas and 18 feet in the lobby -- are practically unheard of in other elder-care facilities.

A roof deck provides outdoor space for residents to take in city views and tend to flowers and vegetables in their own private patch of soil.

A double room runs about $200 a day, while a private room can cost as much as $360 a day for residents who require more specialized care. There are three levels of assisted care that range from $40 to $80 a day. These prices include everything from utilities and linens to bedroom furnishings and weekly housekeeping visits. The only supplemental fees are outside transportation, caregiver attendance for medical and dental appointments, and incontinence supplies.

After eight months, the new community is at 75 percent capacity. Last month, AgeSong received the American Society of Aging's 2006 Business Award for best small business in the aging industry.

Family dynamics

Decision making among five strong-willed, opinionated family members (Bijan is a cousin) is no easy feat. Especially when they've come to AgeSong from such disparate disciplines.

Nader Shabahangi, the philosopher, is AgeSong's president of program development; Ali Shabahangi, the lawyer, is president of development and general counsel; Amir Kia, the businessman, is CEO; Elke Tekin, the marketing guru, is vice president of community relations; and, Leila Bijan, the architect, is, well, still the architect. Throw in Vice President of Operations and Development Chad Lewis, a former publisher and editor, and the only non-blood-relative business partner, and you have an impressive mix of approaches, processes and communication styles.

As Tekin tells it, each of them came from jobs that were, "OK, but maybe not the most fulfilling."

Therapeutic environment

AgeSong is an acronym for awareness, growth, excellence, spirit, openness, nurturing and giving back, which are the values that guide it. It emphasizes caring for its residents' emotional, spiritual and psychological needs in addition to their physical health.

At AgeSong communities, residents mingle for afternoon tea, choose their own daily activities, such as yoga and dance, and pursue hobbies, such as painting and pottery. But they also struggle with the mundane and often unspoken facts of aging: disability and dementia, changing relationships and shrinking independence.

The goal of AgeSong's caregivers is to help residents feel safe and supported, regardless of their age, health or present mood. "As we age, there is often a loss of hope. We stop communicating our dreams," says Tekin. "We've created a therapeutic environment where people can be who they really are." Pictures of the Shabahangis' grandparents hang on the wall to "keep an eye on us, and make sure we're doing it right," she says.

The company seeks out urban settings for its communities that encourage interaction between its residents and the outside world. "When you're old, you want the world to come to you," Shabahangi says. "This is why building in urban communities is so important. It brings the young and old closer together and empowers our elders with a sense of purpose."

Shabahangi and his brothers all own residences in Hayes Valley and are often on-site at the communities. "Hayes Valley has been very welcoming of our business," he says.

Robin Levitt of the Hayes Valley Neighborhood Association thinks AgeSong has brought depth to the neighborhood. "All age, socio-economic, educational and racial groups are represented here. Seniors have an important place in this community," she says.

The AgeSong caregiver team is made up of physicians, nurses, social workers, licensed mental health professionals and nutritionists. It offers residents interdisciplinary programs in assisted living, dementia, memory improvement, behavioral health care and a hospice program in partnership with the Zen Hospice Project.

Residents can join current events discussions, poetry and life-story writing groups, and flower arrangement classes. There are also barbecues, movie nights, and field trips to Las Vegas and Tahoe, as well as to the symphony, opera and local museums.

This kind of therapeutic, holistic care doesn't come cheap. AgeSong falls on the upper end of the elderly care spectrum, although 20 percent of residents are Supplemental Security Income (SSI) recipients who are referred through and subsidized by the San Francisco Public Health Department.

The value of aging

In keeping with its mission to challenge stereotypes about aging, this summer AgeSong will present "Faces of Aging," a photography exhibit at Laguna Grove Care featuring portraits of the elderly. "We want to promote the idea of loving people for who they are at every age," says Shabahangi.

"Society teaches us to see each new crease or sag as a personal failure. We don't look in the mirror and say, 'Shucks, I wish I knew less,' so why do we wish we were younger?"

This sentiment supports AgeSong's holistic view that wisdom comes with life experience, which naturally means getting older and -- despite what makers of Botox and $200 face creams would have you believe -- looking your age.